脑内神经网络修复关键点的临床验证

背景：细胞移植的安全有效靶点选择，是临床研究的重要方向。对脑内是否存在能发挥重要治疗作用的点或区域，以最大限度对神经网络发挥良性影响进而修复，是研究先行者必须优先考虑的课题之一。 目的：通过临床资料分析，证实细胞移植脑内神经网络修复关键点(KPNNR)理论的客观性、真实性和实用性。 方法：2003-05/2009-01共有631例各类中枢神经系统疾病患者接受神经网络修复关键点嗅鞘细胞移植，其中609例资料齐全，男392例，女217例；年龄1.2~84(42.87±19.64)岁，病程0.4~35(5.11±5.46)年。疾病分布：肌萎缩侧索硬化432例次、脑性瘫痪110例次、多发性硬化25例次、共济失调12例次、多系统萎缩7例次、遗传性痉挛性截瘫6例次、持续性植物状态6例次、痴呆2例次、脑缺氧后遗症2例次、帕金森叠加综合征2例次、非特异性脑炎后遗症2例次、肾上腺脑白质营养不良1例、核黄疸后遗症1例、皮质基底核变性1例。患者来自75个国家或地区。 结果与结论：细胞移植后随访2~8周，平均4周，609例次中526例次神经功能获不同程度改善，近期总改善率为86.37%，其中肌萎缩侧索硬化改善率为87.96%。脑性瘫痪改善率为82.7%，特别是4例伴有癫痫者，术后发作明显减少。共济失调改善率为83.3%。遗传性痉挛性截瘫改善率为83.3%。围手术期出现不良事件共33例次，发生率为5.4%，主要为术后头痛、发热等，多经对症治疗后痊愈。结果提示，大脑内神经网络修复关键点(KPNNR)客观存在，在该点进行嗅鞘细胞移植安全可行，能改善多种中枢神经系统疾病患者的神经功能和(或)延缓病情的进行性恶化。

Clinical practice of brain key points for neural network restoration

BACKGROUND: Safe and effective target choice of cell transplantation is an important direction for clinical research. Whether the point(s) or region(s) exist in the brain that play an important role in maximizing positive impact on the neural network to play and then repair, which is one of the key topics, must be studied priority by the forerunners. OBJECTIVE: To explore the objectivity, authenticity and practicality of the theory of key point for neural network restoration (KPNNR) related to cell intracranial transplantation by clinical data analysis. METHODS: Between May 2003 and January 2009, a total of 631 patients with central nervous system diseases underwent the olfactory ensheathing cell (OEC) graft into KPNNR. Of them, 609 patients had complete clinical information: 392 males and 217 females. Their age ranged from 1.2 to 84 (mean 42.87±19.64) years and course of disease was from 0.4 to 35 with an average of (5.11±5.46) years. Disease distribution: 432 patients suffered from amyotrophic lateral sclerosis, 110 cases of cerebral palsy, 25 cases of multiple sclerosis, 12 cases of ataxia, 7 cases of multiple system atrophy, 6 cases of hereditary spastic paraplegia, 6 cases of persistent vegetable state, 2 cases of dementia, 2 cases of sequela of cerebral anoxia, 2 cases of Parkinsonism plus syndrome, 2 cases of non-specific encephalitis sequelae, 1 case of adrenoleukodystrophy, 1 case of kernicterus sequelae, and 1 case of corticobasal degeneration. The patients came from 75 countries or regions. RESULTS AND CONCLUSION: The patients were followed up for 2 to 8 weeks, with an average of four weeks, after cell transplantation. Among 609 cases, 526 cases had neurological function improvements at different levels. The overall improvement rate was 86.37%. Of them, the effective rate in amyotrophic lateral sclerosis was 87.96%. The improvement rate in cerebral palsy was 82.7%, especially, 4 patients who accompanied with epilepsy reduced attack significantly. The improvement rate in ataxia was 83.3%. The improvement rate in hereditary spastic paraplegia was 83.3%. Perioperative adverse events occurred at a total of 33 cases, with the occurrence rate of 5.4%, mainly headache, fever and so on, which were cured by symptomatic treatment. Results suggest that the therapeutic method of OEC transplanted into KPNNR is simple, safe, and feasible, which can improve the function of patients with a variety of central nervous system of neurological diseases and/or slow down the progressive deterioration of some degenerative diseases.